**Core Concept**
The selection of a screening test for a disease involves evaluating various factors to ensure its suitability for detecting the condition in a population. This includes considering the test's sensitivity, specificity, and predictive values, as well as its ease of administration, cost-effectiveness, and impact on public health.

**Why the Correct Answer is Right**
The correct answer is **Cost-effectiveness**. While cost-effectiveness is an essential consideration in healthcare decision-making, it should not be the primary factor in selecting a screening test. A screening test should be chosen based on its ability to accurately detect the disease, minimize false positives and negatives, and be feasible for widespread implementation. Cost-effectiveness is an important secondary consideration that should be evaluated once a suitable test has been identified.

**Why Each Wrong Option is Incorrect**
**Option A:** **Sensitivity**. Sensitivity is a critical factor in selecting a screening test, as it determines the test's ability to detect true positives. A highly sensitive test is essential for identifying individuals with the disease.

**Option B:** **Specificity**. Specificity is also a crucial factor in selecting a screening test, as it determines the test's ability to exclude false positives. A highly specific test helps avoid unnecessary further testing and reduces the risk of misdiagnosis.

**Option C:** **Predictive values**. Predictive values, including positive predictive value (PPV) and negative predictive value (NPV), are essential in evaluating the performance of a screening test. They provide insight into the probability of disease given a positive or negative test result.

**Clinical Pearl / High-Yield Fact**
When selecting a screening test, it's essential to prioritize sensitivity and specificity over cost-effectiveness. A highly sensitive and specific test may be more expensive, but it will ultimately lead to better outcomes and more accurate diagnoses.

**Correct Answer:** D.